Patient History
Posterior knee pain in a 14-year-old female after a gymnastics injury 3 weeks prior. Assess for meniscus tear.
Findings
Menisci:
Medial Meniscus: Large bucket-handle tear extending from the posterior root to the anterior root, with a displaced inner fragment extending into the intercondylar notch. Tear extends a distance of approximately 6 cm.
Lateral Meniscus: Intact incomplete (partial) discoid meniscus.
Ligaments:
Anterior Cruciate Ligament: Intact.
Posterior Cruciate Ligament: Intact.
Medial Collateral Ligament: Intact.
Lateral Collateral Ligament: Intact.
Posterolateral Corner Structures: Intact.
Posteromedial Corner Structures: Intact.
Extensor Mechanism:
Patellar Tendon: Intact.
Distal Quadriceps Tendon: Intact.
Medial Patellofemoral Ligament: Intact.
Medial and Lateral Patellar Retinacula: Thickened lateral retinaculum. Unremarkable medial retinaculum.
Hoffa’s Fat Pad: Focal induration and thickening of the infrapatellar plica with focal edema in Hoffa’s fat pad superolaterally.
Articulations:
Patellofemoral Compartment: Unremarkable.
Medial Compartment: Osteochondritis dissecans involving the lateral aspect of the medial femoral condyle as described below. Otherwise unremarkable.
Lateral Compartment: Unremarkable.
General:
Bones: 2.2 x 1.1 cm area of osteochondritis dissecans involving the posterolateral aspect of the medial femoral condyle (weight-bearing surface). Overlying cartilage intact. No crescent sign or subchondral cystic change to suggest instability. No displaced fragment.
Effusion: Moderate-sized suprapatellar effusion.
Baker’s Cyst: None.
Loose Bodies: None.
Soft tissue and neurovascular: Unremarkable.
Conclusion
1.Large Bucket-handle tear medial meniscus. Displaced inner fragment extends into the intercondylar notch.
2.Incidental healed osteochondritis dissecans medial femoral condyle with intact overlying cartilage. No MRI evidence for instability.
3.Incidental partial/incomplete discoid lateral meniscus.
